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The community care reforms of the last decade seem to have had a positive impact on patient suicide - providing more intensive support to the most vulnerable patients appears to have improved their survival”

End QuoteProf Louis ApplebyUniversity of Manchester

Nine of the recommendations were analysed. At the end of the study in 2006, the suicide rate was 9.1 per 10,000 patient contacts in a year for authorities which had introduced at least seven of the measures. The rate was higher, 11 per 10,000, for those which had introduced six or fewer.

Prof Nav Kapur, from the University of Manchester, told the BBC: "We estimate that there were 200 to 300 fewer suicides per year" as a result of the measures.

His colleague Prof Louis Appleby said: "There has been very little evidence on what makes services safer.

"The community care reforms of the last decade seem to have had a positive impact on patient suicide - providing more intensive support to the most vulnerable patients appears to have improved their survival."

The way the study was conducted means it cannot say that the reforms caused a reduction in suicide rate, as other changes in society at the time could have had an impact.

However, by comparing figures immediately before and after the reforms, the researchers are confident that the changes did have an affect.

Dr Yeates Conwell, from the University of Rochester Medical Center, said the work was "important" as: "We cannot take for granted that even the most seemingly obvious intervention designed to reduce suicide is necessarily effective without evidence."

She added: "While necessary, an approach that targets only high-risk individuals will have a marginal effect on overall suicide rates, because most people who take their own lives have had no contact with mental health services."

Dr Peter Byrne, from the Royal College of Psychiatrists, said: "We welcome this excellent study showing how local implementation of comprehensive mental health services reduces the number of people who die by suicide.

"It proves the value of investing in safe psychiatric wards, close follow-up of discharged patients and specialised teams."

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